EFFECT OF MENOPAUSAL TRANSITION ON SLEEP DETERIORATION IN WOMEN DURING AGING PROCESS: A 4-YEAR FOLLOW-UP STUDY FROM A LONGITUDINAL COHORT

초록

Introduction: Perceived sleep problems become more prevalent in women compared to men, especially during the aging process, and it is known that menopause is one of the major inflection points in middleaged women. However, limited data exist to understand the respective impact of menopause and the aging process itself that deteriorates various sleep characteristics in women. Materials and Methods: In this study, we examined a 4-year longitudinal data of 1,211 women participants collected as part of the Korean Genome and Epidemiology Study (KoGES). The subjects were grouped into three menopausal stages: pre-menopausal, peri-menopausal, and post-menopausal. The sleep characteristics assessments were based on the Pittsburgh Sleep Quality Index (PSQI). Besides the conventional component estimation of the PSQI, we further evaluated the individual sleep characteristics (e.g., time in bed, mid-time sleep) as continuous variables. Regression analyses were conducted to examine the impact of the menopausal stage on the deterioration of sleep over time, considering age, education level, household income, marital status, drinking status, and body mass index. Results: Among 1,211 women included, 553 (46%; 56.89 ± 6.83 years old) were post-menopausal, 242 (20%; 47.61 ± 2.89 years old) were perimenopausal, and 416 (34%; 44.58±2.12 years old) were pre-menopausal group. Compared to baseline, both peri- and post-menopausal groups showed higher PSQI, longer sleep latency and time in bed, and less habitual sleep efficiency after 4-year follow-up (all p < .02). In addition, the postmenopausal group also exhibited earlier mid-sleep time (p < .041) after 4 years. Compared to the pre-menopausal group, the peri-menopausal group exhibited a significant increase in sleep latency (b [SE] ¼ 4.370 [1.603]; p ¼ 0.007), and the post-menopausal group exhibited an increase in PSQI (b [SE] ¼ 0.627 [0.279]; p ¼ 0.025) and advancement in mid-sleep time (b [SE] ¼ -0.178 [0.076]; p ¼ 0.02). Conclusions: The present study suggests that various deteriorating sleep characteristics during the aging process among middle-aged women are differently affected by menopausal status.